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LAND USE PERMIT APPLICATION — Burnett County, WI a 1 <br /> Applicant Complete All Sections Below This Line 0" <br /> Permit Types and Fees(Please,check appropriate boxes) C7 <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 .. O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 c, <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> n <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 ° <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 —r- ,..), F <br /> Filling/Grading $150 Boathouse $500 <br /> v) <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 Ni <br /> � <br /> *NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. `& ' " <br /> ;I'*Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. ; 1 <br /> • <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. o ' , <br /> g <br /> 0 <br /> Property Owner's Name: Steve Herrmann -r' N <br /> °o W • <br /> a. , <br /> Property Owner's Mailing Address: 403 E. Third St Chaska, MN 55318 n LIt II <br /> City State Zip <br /> Property Site Address: 8606 W Bass Lake Road < —� <br /> Contact's Telephone Number: 612-817-8533 a <br /> d <br /> P <br /> Contact's Email: sherrmann.mn(c�gmail.com <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is NJ - <br /> legible and your email provider will accept emails from the following address: @BurnettCountyWI.gov = °° tv <br /> OP N <br /> Legal Description of Property: 07-036-2-40-17-14-5 05-003-041000 <br /> 5RI <br /> Section#: 14 Town#: 40 N Range#: 17 W Town of: Union W <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* v) <br /> o w-� <br /> Tax ID#(1-5 digit number; found on tax statement): 24788 3 k <br /> 0 <br /> Proposed Use of Structure/Addition: Additional Living Space -i N <br /> Anticipated Start Date: 1/1/2024 (Home/Cabin;Commercial Business;Bedroom;/ Deck;etc.) —• ..0 <br /> Building Contractor: Sewer Installer: 1t-InS 5ci, C.3 <br /> • <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY m° <br /> r z <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: 'z <br /> v <br /> Dieu- aU 5<yfriotck <br /> m <br /> a <br /> n <br /> Seer -It 6- rm�veat Qf >� <br /> �OnLkd 4 Sc1fI-f v S/ 7—n@UkY ° Check#:(wa5yN <br /> N I r- <br /> 6 Zp2`I 15% : buS Sur-face . I -fie ►mrrpvtiv> f 1 I mo. <br /> `T ear IS r aktc1q YET f t/u1 tt 1-1-i)a <br /> Date of staff site visit: Z 242 o2q Ini 'als of site visit staff: ' ` 1 <br /> — c � <br /> APPROVED BY LAND SERVICES OFFICIAL. DATE: 212(e 7-624 b co <br /> Q -n�ffi <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF co a w 0 <br /> a - <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT 0 0 <br /> cD <br /> �,< <br /> Page l of 5 1 f <br /> Burnett County, WI Land Use Application—Rev 12/2023 - �� <br />